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Save ECLIPSE claiming attributes

Managing Billing Agents, Facility IDs, Fund Payee IDs, LSPNs, and SCP IDs.

Nick avatar
Written by Nick
Updated over a week ago

About 'claiming attributes'

You can save various claiming attributes to select from later during OEC and claim submissions. Stored values will appear in the relevant field's drop-down for selection, so repeatedly used values can be easily recalled during submission and not manually entered each time.

Below is the list of available claiming attributes and more information about each is included within this article:

To add a new claiming attribute, e.g. "Facility ID" navigate to the ECLIPSE settings from the ‘GET PAID’ page and scroll down to the ‘ECLIPSE claiming attributes' section, then select the ‘Facility ID’ tab, then click the 'ADD NEW FACILITY ID' button. Once added, you can also edit or remove entries from here by clicking on the three horizontal dots (shown below).

List of available claiming attributes

Billing agents

This is the registration number provided by Medicare for approved Simplified Billing Agents. When used, benefits payable will be issued to the Billing Agent rather than the Principal Provider.

Facility ID

The hospital provider number where the admission took place - otherwise known as the Commonwealth Hospital Facility Provider Number.

Fund Payee ID

A 'Fund Payee ID' is a Private Health Insurer (PHI) Agreement identifier for the practitioner and is issued by a PHI (used to map Fund payment arrangement details and direct payments for approved PHI claims). Most PHIs require the provider to submit a Fund Payee ID for eligibility check or claim.

Fund Payee ID is optional, but only for the following claim types: AG (Agreement); SC (Scheme); or MB (Billing Agent) - cannot be set for PC (Patient Claim) or MO (Billing Agent - Medicare Only).

A Fund Payee ID will be allocated to a provider on registration with a PHI and is used to direct financial settlements for approved claims. For AHSA funds, the Fund Payee ID is the usually the same as the provider number.

This ID does not need to be registered with Tyro health, but can be added in advance or manually entered at time of claim submission under ECLIPSE settings. If you cannot find your Fund Payee ID, you'll need to reach out to the PHI.

LSPN

Location Specific Practice Number (LSPN) is used and required for certain Diagnostic Imaging and Radiation Oncology services. Set for:

  • Services listed in the Diagnostic Imaging Services Tables (DIST); and

  • Group T2 - Radiation Oncology services (General Medical).

Must be set when both a 'field quantity' is entered and the ‘referral type code’ is set to “Diagnostic Imaging”. Must not be set when ‘service type code’ is “Pathology” or “General”.

SCP ID

Specimen Collection Point (SCP) ID is used to identify the site where the pathology specimen was collected. Only applicable when ‘service type code’ is set to “Pathology”.


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